Schizophrenia is rarely referred to in Lacan’s scholarship, and even more rarely in the socalled later Lacan. Yet the French psychoanalyst’s teaching on knotting and the theory of the sinthome of the 1970s can be utilized for the theoretical and clinical approach to this psychotic type. The gradual emphasis on the real in Lacan’s teaching can act as a guide both for its conceptualization and for the treatment supported by those clinicians who see schizophrenic subjects. My investigation of the conceptual history of schizophrenia led to the conclusion that despite psychiatric scholars having noted from early on an aspect that pertains to the real – schizophrenic discourse – this was disregarded, having been deemed one of the condition’s numerous morbid outcomes. In the same way, early psychoanalysts emphasized the aspect of subjectivity that Lacan calls the imaginary in the treatment of schizophrenia, trying, thus, to address it via a mechanism typical of the other major psychotic type, paranoia. This approach does not seem consonant with Freud’s reading of the two types, although he never elaborated upon their differentiation beyond the early 1910s. In fact, although the suggested Lacanian approach to schizophrenia derives from the last decade of Lacan’s teaching, it has roots in Freud’s view of psychosis of the mid-1910s and early 1920s. I have attempted to create a paradigm for the impact of those findings in examining the case of the late-19th-century Greek poet, writer and scholar Georgios Vizyenos. I argue that Vizyenos was characterized by a schizophrenic’s relation to the body, language, and the social bond. In his life and work, examined in detail, we see how the cause, triggering, and temporary treatment of his psychosis are linked to a concept with a direct relation to the real: ‘child’. Testimonies from Vizyenos’ childhood show his resistance to semblance, which had specific effects upon his body. It is, then, demonstrated how in late adolescence and mature life the subject renamed himself and acquired a sense of his body thanks to a ‘modified’ narcissism that did not resemble the coordinates of the paranoiac’s ego. This construction is approached through the later Lacan’s theories of the sinthome and the escabeau. Finally, it is shown how that invention was temporary, with Vizyenos being unable, in the end, to avoid the return of jouissance to the subject’s body. The theoretical and clinical implications of the study of Vizyenos’ case are discussed in relation to the contemporary Lacanian approach to schizophrenia. It is suggested that the singular character of the subject’s relation to the real could lead us to cross schizophrenia with a bar, schizophrenia, as Lacan did for the signifier ‘woman’ in his later teaching. Thus, the sinthomatic approach, which emphasizes the subject’s relation to the real rather than the universal subscription to Oedipus, does not seem unsuitable for the treatment of subjects who are schizophrenic. This is argued at greater length by comparing it with psychoanalytic orientations that place more emphasis on the use of the imaginary or the symbolic.